慢性阻塞性肺疾病与支气管哮喘患者血浆抗菌肽LL-37水平的比较

目的比较慢性阻塞性肺疾病(COPD)与支气管哮喘(哮喘)患者血浆中LL-37水平的异同,以期对COPD的鉴别诊断有所帮助.方法研究对象为2016年5月至2017年4月于北京医院就诊的COPD、哮喘患者和同期健康体检者.根据2014年COPD全球策略的病情严重程度评估标准,将纳入的COPD患者分为(A+B)组和(C+D)组2个亚组.检测各组血浆中LL-37水平,比较各组间LL-37水平的差异,并探讨LL-37水平与肺功能等指标之间的关系.结果共纳入COPD组患者129例,其中(A+B)组69例,(C+D)组60例;哮喘组患者60例;健康体检者60例(对照组).对照组、哮喘组、COPD组的血浆LL-37水平分别为(19.7±4.8)μg/L、(18.7±4.5)μg/L、(17.8±4.2)μg/L,各组间比较差异无统计学意义.(C+D)组血浆LL-37水平(15.2±2.6)μg/L]明显低于哮喘组(18.7±4.5)μg/L]、对照组(19.7±4.8)μg/L]和(A+B)组(20.1±4.0)μg/L](F=6.422,P<0.001).COPD患者血浆LL-37水平与第1秒用力呼气容积(FEV1)、FEV1%pred之间均呈显著正相关(r=0.488、0.554,P=0.005、0.001),与改良英国医学研究委员会呼吸困难量表呼吸困难指数之间呈显著负相关(r=-0.397,P=0.022).结论急性加重风险较高的COPD患者血浆中的LL-37水平明显低于哮喘患者和健康人.

Plasma cathelicidin LL-37 levels in chronic obstructive pulmonary disease and bronchial asthma patients

Objective To explore the difference of plasma cathelicidin LL-37 levels in bronchial asthma(asthma)patients and chronic obstructive pulmonary disease(COPD)patients.Methods COPD patients,asthma patients and normal subjects were recruited at Beijing Hospital from May 2016 to April 2017 for this study.COPD patients were divided into(A+B)subgroup and(C+D)subgroup,depending on disease severity.The level of LL-37 in the plasma of each group was measured,and the difference of LL-37 level between each group was compared,and the relationship between LL-37 level and lung function was discussed.Results There were 129 COPD patients(COPD group),60 asthma patients(asthma group)and 60 normal subjects(control group),included COPD patients were divided into(A+B)subgroup(69 cases)and(C+D)subgroup(60 cases),according to the disease severity criteria of 2014 GOLD strategy.The plasma LL-37 levels in control group,asthma group and COPD group were(19.7±4.8)μg/L,(18.7±4.5)μg/L and(17.8+4.2)μg/L.There was no differences between these groups.The plasma levels of LL-37 in(C+D)group(15.2+2.6)μg/L was significantly lower than asthma group(18.7±4.5)μg/L],control group(19.7±4.8)μg/L]and(A+B)group(20.1±4.0)μg/L(F=6.422,P